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OPTUM PHARMACY 702, LLC
CH030700 CENTRAL VIRGINIA HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
CENTRAL VIRGINIA HEALTH SERVICES, INC.
Subdivision Name
CVHS Buckingham
Type
HRSA-Funded Health Center
340B ID
CH030700
Entity Address
25892 N James Madison Hwy
New Canton, VA 23123-2234
Grant Number
H80CS00479
Participating Start Date
7/1/1995
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
OPTUM PHARMACY 702, LLC
Pharmacy Address
1050 PATROL RD
JEFFERSONVILLE, IN 47130
Pharmacy Comments
Contract Details
Approval Date
1/15/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paula Anne Tomko, Chief Executive Officer
(434) 581-3276
Contract Pharmacy Representative
Optum
Nancy McCutcheon, SR VP of Strategic Sales
(651) 983-0677
Signed By Date
1/15/2024
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